A.w. Holdings LLC
Cost Outlier
Billing over 3× the national median for specific procedure codes.
This provider bills $11,967.18 per claim for H2016 (Comprehensive community support services, per 15 min), which is 37.2× the national median of $321.53.
Rate Outlier
Billing above the 90th percentile across multiple procedure codes simultaneously.
Billing above the 90th percentile for 5 procedure codes: H2016 at 37.2× median, 99600 at 3.0× median.
Statistical flags are not proof of wrongdoing. Some entities (government agencies, home care programs) may legitimately bill at high rates. Hospitals, government entities, and large care organizations may legitimately bill at higher rates due to patient acuity, overhead costs, or specialized services. Read our methodology.
Red Flags Explained
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Each flag represents a statistical test that identified unusual billing patterns. Here's what each flag on this provider means in plain English:
Cost Outlier
Cost Outlier means this provider charges significantly more per claim than other providers billing the same procedure codes. This could indicate upcoding, inflated charges, or specialized services that justify higher costs.
Rate Outlier
Rate Outlier means this provider charges above the 90th percentile for multiple different procedure codes simultaneously. While one high-cost code could reflect specialization, consistently high rates across many codes may indicate systematic overbilling.
These flags are statistical indicators only. Many flagged providers have legitimate explanations for their billing patterns. Learn more about our methodology.
Risk Assessment
Bills $11,967.18 per claim for H2016 (Comprehensive community support services, per 15 min) — 37.2× the national median of $321.53.
Bills $335.68 per claim for 99600 (Unlisted home visit service or procedure) — 3.0× the national median of $111.99.
Bills $2,482.38 per claim for T2021 (Day habilitation, waiver; per 15 min) — 16.5× the national median of $150.51.
Billing in the top 1% nationally for 2 procedure codes: H2016, T2021.
This is a statistical summary, not an accusation. See our methodology.
Compared to Psychologist Intellectual & Developmental Disabilities Peers
Total spending distribution among 6 providers in this specialty
This provider's total spending of $260.2M is at the 75th percentile among 6 Psychologist Intellectual & Developmental Disabilities providers.
Total Paid
$260.2M
$260,208,798
Total Claims
961K
Beneficiaries
258K
3.7 claims/patient
Avg Cost/Claim
$271
#318 of 618K providers by total spending(top <0.1%)
🔍 Analysis
Provider Overview
A.w. Holdings LLC is a Psychologist Intellectual & Developmental Disabilities provider based in Fort Wayne, IN. From the 2018–2024 period, this provider received $260.2M in Medicaid payments across 961K claims.
Why This Matters
This provider received $260.2M in taxpayer-funded Medicaid payments — enough to fund healthcare for approximately 32,526 Medicaid beneficiaries for a full year at average per-enrollee costs.
Monthly Spending Trend
Yearly Spending
Procedure Breakdown
Cost per claim compared to national benchmarks
This provider bills for 24 distinct procedure codes. The top code (H2016 (Comprehensive community support services, per 15 min)) accounts for 42% of total spending.
$110.5M
9K claims
$11,967.18
$321.53
Comprehensive community support services, per 15 min
$110.5M
9K claims · 42.4%
$54.6M
69K claims
$794.78
$331.94
Habilitation, residential, waiver; per diem
$54.6M
69K claims · 21.0%
Case management, each 15 min
$28.7M
651K claims · 11.0%
$25.9M
77K claims
$335.68
$111.99
Unlisted home visit service or procedure
$25.9M
77K claims · 10.0%
Case management, per month
$18.6M
61K claims · 7.1%
$11.9M
5K claims
$2,482.38
$150.51
Day habilitation, waiver; per 15 min
$11.9M
5K claims · 4.6%
Day habilitation, waiver; per diem
$1.9M
8K claims · 0.7%
$1.6M
11K claims
$136.58
$146.45
Adaptive behavior treatment with protocol modification, per 15 minutes
$1.6M
11K claims · 0.6%
$1.5M
36K claims
$41.14
$69.56
Targeted case management, per 15 min
$1.5M
36K claims · 0.6%
$1.4M
6K claims
$231.29
$88.27
Habilitation, prevocational, waiver, per diem
$1.4M
6K claims · 0.6%
$1.1M
11K claims
$96.70
$167.38
Adaptive behavior treatment by protocol, per 15 min
$1.1M
11K claims · 0.4%
$863K
331 claims
$2,607.78
$225.50
Community psychiatric supportive treatment program, per diem
$863K
331 claims · 0.3%
Waiver services, NOS, per diem
$510K
911 claims · 0.2%
$337K
5K claims
$71.00
$119.08
Evaluation & treatment, integrated specialty team
$337K
5K claims · 0.1%
$324K
3K claims
$123.93
$83.88
Skills training & development, per 15 min
$324K
3K claims · 0.1%
Non-emergency transport; per trip
$269K
3K claims · 0.1%
RN services, per 15 minutes
$173K
2K claims · 0.1%
$76K
1K claims
$53.45
$19.61
Non-emergency transportation, patient attendant or aide
$76K
1K claims · 0.0%
$34K
379 claims · 0.0%
$23K
101 claims
$229.77
$259.38
Supported employment, waiver, per diem
$23K
101 claims · 0.0%
$16K
353 claims · 0.0%
$1K
70 claims · 0.0%
$0
28 claims · 0.0%
$0
242 claims
$0.00
$108.80
Coordinated care fee, maintenance period
$0
242 claims · 0.0%
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